Cognitive Dysfunction & Your Dog

What is Cognitive Dysfunction?

One of the saddest things you may experience in your life is seeing someone you know who was so full of life, so vibrant, so smart…all of the sudden just seem to not be able to think clearly anymore.  Imagine if this was your dog.  Yes, what we see in people such as senility, Alzheimer’s disease, or “sundowners syndrome” can also be seen in dogs (and possibly in cats but much less understood).  The entire cognitive dysfunction syndrome (CDS) has been an emerging area of understanding in the last several years.  While senior pets may show signs that could be attributed to medical issues, those potential diseases should be ruled out before coming to the conclusion of what is considered to be a behavioral problem.

Studies have shown that starting around 6-7 years of age, dogs may start showing signs.  Oftentimes, these go unnoticed until the condition has progressed to severe levels.  Signs can include greater attention seeking to seeming to want to interact less with family, increased anxiety levels in situations that used to not bother them, and becoming less responsive when called or given a command.  And these are the harder ones to note sometimes but also may not be as concerning in the mind of the family.  Signs more likely to get attention are soiling in the house, restlessness at night (stay up all night and sleep in the daytime), or pacing constantly.

What can we do to help?

cognitive dysfunction enrichment

Jennifer & Keltie rally obedience practice

The sooner signs are noted or addressed, the better chance we have of helping a dog’s quality of life.  Much like we encourage enrichment for cats or exotic pets, dogs can benefit from such activities as scent detection, competitive obedience, or agility – activities that help them think and positively stimulate their brains.  Sometimes just playing and interacting with your dog can be a good start.  It’s important to keep in mind any medical or physical limitations, especially as your pup ages.  Adding in toys can always be a good idea especially puzzles or toys that dispense food to keep then thinking and engaged.

Further treatment to help alleviate signs can be found with some medications but their effects may be variable from patient to patient.  Medications and supplements should be discussed with your veterinarian to determine what might work best for your particular dog and what the proper dosages are.  Senior pet diets supplemented with fatty acids, antioxidants, and medium chain triglycerides can also be beneficial.  There is a lot of exciting research and new tools to help these patients coming in the near future.

Due to our ability to better recognize these problems and the tendency for the earliest signs to start at middle to early senior years, it truly is important to have your pet checked out at least once a year.  There may be something we can work on together to help you and your dog live in harmony while working through cognitive dysfunction.  Have you noted any changes or signs mentioned above in your dog?  If so, what have you done that seems to help?

Disclaimer: Blog posts may contain some opinions which are my own and may not reflect those of any current or former employers. 

Don’t forget to follow along on Instagram @drryanllera , Facebook , or  Twitter for more pet info and interesting daily happenings!

Cats, Strings, & Intestinal Things

cats and string

from kittenwhiskers.com

The country song goes “Mamas don’t let your babies grow up to be cowboys…” and the same thing applies to cats playing with string.  Media is chock full of images of kittens playing with balls or yarn whether it be cartoons, advertisements, or the endless supply of cute videos on YouTube.  But behind all this cuteness lies a deadly risk if a cat eats string, thread, yarn, or dental floss.  These kitties can be fixed but it’s not easy.  This is Mira’s story…

Mira cats and string

Mira

Sometimes you see your cat eat the string and sometimes you don’t.  Often times the first thing you may notice is vomiting.  This was the case with Mira.  At just 2 years old, she’s still an intensely curious cat.  All cats may vomit from time to time – hairballs, catching a mouse, chewing on plants, but never just vomiting out of spite.  When Mira started vomiting multiple times over several hours, her family knew something wasn’t right and brought her in to see us at the Kingston Veterinary Clinic.  The diagnosis was easily found as soon as Dr. Vander Wilp, a colleague of mine, saw the string wrapped over and under her tongue.

When a string gets trapped at this spot, the other end of it starts moving through the stomach and intestines.  Essentially what happens is the string begins to act like a saw cutting through the intestines as it pleats them like an accordion.  Palpating a cat’s abdomen like Mira’s you can feel the intestines bunched up and thickened.  At this point, we weren’t sure how long the string had been present.  What we were all sure of was that Mira needed help in the form of surgery.

Yet, surgery isn’t just a simple snap of the fingers.  Many factors need to be considered.  Due to her vomiting, Mira was dehydrated.  With the risk of the string cutting into the intestines, blood and protein gets lost through these injuries which can complicate healing as well as leaking intestinal contents contributing to infection.  And the biggest mystery, what will you do once you’re there actually seeing the abdominal contents.  Mira’s family elected to go ahead and get her fixed up.

cats and string

Mira’s plicated intestines

Once we had her on some IV fluids and got her a bit better stabilized, I took her into surgery and investigated the damage.  In total, 7 perforations were noted and I discovered the other end of the string was in the colon.  Effectively, it was acting like a drawstring on pair of sweatpants pulling on her intestines at both ends.  Due to the number of perforations and their locations, the best option was to remove a large section of intestine and reattach the good ends.  After releasing the ends of the string through separate incisions in the stomach and end of the small intestine, I removed 32cm of the small intestine and reattached the ends before rinsing her abdomen and closing her up to recover her.

Over the next couple of days, we monitored Mira in the hospital.  Things weren’t going as we had hoped.  She wasn’t eating, kept spiking fevers, and seemed generally quieter than expected.  She only would eat tiny amounts when her family visited.  On the third day post-op, we checked some blood as she still wasn’t doing as we expected and noted several changes in the blood cell count and protein levels that concerned us and raised the suspicion that something had broken down inside.  The results were worse than before the initial surgery.  Despite all the precautions and steps we had taken to help Mira, something was leaking.

After some discussion, her family elected to have us attempt a second surgery as a means of fully discovering the extent of the problems and to fix what we could.  As soon as I got back into her abdomen, I had all the explanation we needed.  Her anastomosis site (the reattached portion) had broken down and a small leak was seen near it.  Given the amount of damage that was found and the previously removed section of intestine, I felt it best to call her family immediately and give them an update.  Assessing the extent of everything internally, I let them know her prognosis was very guarded to poor even with attempting a second repair and advised them that euthanasia was not an unreasonable option.  Her family conferred for a moment and told me to do my best to save her.  Back in surgery, I removed as little intestine as possible that was no longer viable and reattached the new ends.  After a very thorough rinsing of the abdomen and closing her back up, we all hoped for the best.

blood donor cat

Pioneer, the blood donor

Great news the next morning!  Her temperature was normal and she greeted us with alertness and purring unlike any other morning before.  A recheck of her blood now showed dangerously low levels of red blood cells and protein.  Mira needed a transfusion to give her the best chances for survival.  Luckily, one of our staff members volunteered to have her cat donate.  Mira received the much needed blood and was on the complete road to recovery.  By the next day, she was feeling spunky, her blood values had improved, and she was eating everything we gave her.  Mira was going home.

cats and string

Mira getting her transfusion

I like to think of Mira as a little “Mira-cle in May.”  Not all cats get this outcome.  It took the right combination of family commitment, veterinary team care, and a bit of luck.  The important message here is that when your pet seems sick, it’s best to not wait to see if it will pass — at a minimum, please talk with your veterinarian.  Waiting too long could make things worse.

Disclaimer: Blog posts may contain some opinions which are my own and may not reflect those of any current or former employers. Mira’s story is published with permission from her owners and some non-essential details have been omitted for brevity.

Don’t forget to follow along on Instagram @drryanllera , Facebook , or  Twitter for more pet info and interesting daily happenings!

Why Wounds Shouldn’t Wait

The warmer weather has finally arrived.  Dogs and cats are out playing.  Outdoor cats are once again patrolling their territory.  Sometimes that playtime or territorial behavior can end up in somebody getting  a cat or dog bite wound or other type of injury caused by their exploration.  You know what else is back?  Bugs….specifically flies, mosquitoes, fleas, and ticks – but more on this later.

Superficial wounds would classify as scrapes, scratches, abrasions, and bruising.  In many of these cases, they can be addressed at home by basic first aid cleaning.  Yet, if it doesn’t seem to be going well, you should get your pet in to be checked by their veterinarian.  It’s the nasty bite wounds and lacerations that I’m mostly worried about.

dog bite wound

A wound that waited too long

In medicine, we have what is called the “golden period” when discussing wounds.  This is the optimal time period in which we have to clean and repair a wound.  Over the course of history, the length of time has varied between 6-24 hours.  Generally, after this time, wound repair becomes more complicated as the edges have generally dried up or become necrotic.  This is the real reason it’s a bad idea to wait or try to treat these larger or deeper wounds at home.  The longer it takes for a wound to be addressed leads to increased pain, risk of infection, time to heal, and increased costs.

dog bite wound

Drain placement for a pocketed wound

Some wounds might be simple punctures.  Yet, some of those puncture wounds also include pulling away of the skin from the underneath subcutaneous layers.  This creates a pocketing effect where inflammatory fluid can accumulate.  If the hole closes up too quickly and the wound hasn’t been adequately flushed, this is how abscesses are created and drain will need to be placed during a surgical procedure.  The time it may not go exactly this way is bite wounds on the legs which causes a diffuse, painful inflammation around the muscles and nerves – this is one of the most common reasons I see outdoor cats limping.

From Univ. of Florida Entomology Dept

Remember those bugs?  Flies are the worst ones when it comes to wounds as they have no decency!  Some flies may lay eggs in a pet’s wound and when that happens what amounts to an alien horde is going to beam down next.  Once the eggs hatch, you get maggots.  Ick!  While they prevent the wound from healing, they can also lead to further infection and pain.  Maggots need to be cleaned out, in one piece, and the dead tissue needs to be removed followed by additional treatments.  Breaking or crushing maggots could lead to the release of substances that can cause shock, an anaphylactic reaction, or even death.

As you can see, wounds can be a serious matter and in some cases just “waiting to see how they turn out” could lead to further problems.  At a minimum, get it checked out and don’t delay.  Early intervention can prevent bigger problems in the long run!

Disclaimer: All blog posts are my own opinion and do not reflect those of any current or former employers.

You can also find me on Instagram @drryanllera and as always on Facebook & Twitter!

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